Dr. David Kim
Board-Certified Plastic Surgeon, MD, FACS
Under the muscle (submuscular) is chosen about 80% of the time and for good reason: the muscle provides extra tissue coverage, making the implant edges less visible and reducing the risk of visible rippling. It also produces a more natural slope in the upper pole. The downsides are a slightly longer recovery and a temporary animation deformity (implant movement during chest flexion). Over the muscle (subglandular) has a shorter recovery, no animation deformity, and can look more projected. However, it carries higher risks of visible edges and rippling, especially in thin patients, and a slightly higher rate of capsular contracture. If you have very little natural breast tissue, under the muscle is almost always better. If you have moderate existing tissue and want a perkier look, over the muscle can work well. A newer option—dual-plane placement—combines benefits of both by partially placing the implant under the muscle.